Component ultrasound transducer

ABSTRACT

An ultrasound transducer having multiple focal zones is described. In one embodiment there is an ultrasound transducer manufactured as a single piece but having two or more focal zones. In a second embodiment there is a transducer assembly combining a high frequency and low frequency transducer. In a third embodiment there is an interchangeable assembly allowing for different ultrasound transducers to be used based on procedural needs. Variations of each embodiment are also disclosed.

CROSS-REFERENCES TO RELATED APPLICATIONS

This application claims the benefit of provisional application No.60/534,034 (Attorney Docket No. 021356-001300US), filed on Dec. 30,2003, the full disclosure of which is incorporated herein by reference.

The subject matter of the present application is related to that of thefollowing applications: Ser. No. 10/750,370, entitled “Medical DeviceInline Degasser” (Attorney Docket No. 02356-000500US); Ser. No.10/751,344, entitled “Articulating Arm for Medical Procedures” (AttorneyDocket No. 02356-000600US); Ser. No. 10/750,369, entitled “DisposableTransducer Seal” (Attorney Docket No. 02356-000700US); 60/533,528,entitled “Position Tracking Device” (Attorney Docket No.021356-000900US); 60/533,988, entitled “Method for Planning andPerforming Ultrasound Therapy” (Attorney Docket No. 021356-001000US);60/534,036, entitled “Ultrasound Therapy with Hood Movement Control”(Attorney Docket No. 021356-00100US); and 60/533,958, entitled “Systemsand Methods for the Destruction of Adipose Tissue” (Attorney Docket No.021356-001200US); the full disclosure of each of these applications areincorporated herein by reference.

BACKGROUND OF THE INVENTION

1. Field of the Invention

The present invention relates to ultrasound transducers devices for thedestruction of adipose tissue through the projection of ultrasoundenergy into adipose tissue without an invasive component. In particularthis invention details transducers having multiple focal points, ordevices using multiple transducers to perform non-invasive adiposetissue destruction.

2. Description of the Prior Art

Body sculpting has developed into a highly sought after procedure forreducing a person's weight and restoring people to a leaner, trimmerphysique. The field of cosmetic surgery has ballooned considerably withdevelopments in both tools and techniques. One of the more popular forboth quick weight loss and body sculpting is liposuction.

Liposuction is a method of body contouring that can dramatically improvethe shape and contour of different body areas by sculpting and removingunwanted fat. More than 200,000 liposuction procedures are performedannually. Recent innovations and advances in the field of liposuctioninclude the tumescent technique and an ultrasonic assisted technique.Traditional liposuction was done by making small incisions in desiredlocations, then inserting a hollow tube or cannula under the skin in thefat layer. The cannula is connected to a vacuum and the fat is vacuumedout under high suction pressure. This procedure indiscriminately removedfat, connective tissue, blood vessels and nerve tissue. The procedurecaused bleeding, bruising, trauma, and blood loss, restricting theamount of fat removal possible.

The Tumescent technique allows for removal of significantly more fatduring the operation with less blood loss. Tumescent liposuction injectsa fat layer with large amounts of saline and adrenalin solution beforesuctioning. A cannula is again used with a suction device to remove fat.This procedure reduces the bleeding of traditional liposuction. Howeverthe procedure still removes a significant amount of structural tissue,blood and nerve endings.

The most recently approved innovation is Ultrasound Assisted Lipoplasty(UAL). UAL utilizes a titanium cannula that has the tip vibrating atultrasound frequency. This vibration disrupts the near volume fat cellsand essentially liquefies them for easy removal. UAL uses a low powersuction and draws the fat material only in the near vicinity of thecannula tip. This technique is more refined and gentle to the tissues,there is less blood loss, less bruising, less pain, and a significantlyfaster recovery.

The use of ultrasound for surgical procedure is not restricted to UAL.High intensity focused ultrasound (HIFU) techniques have been employedby others for cancer therapy.

U.S. Pat. No. 6,309,355 to Cain et al., discloses a method of generatingmicro-bubbles in a target tissue and then using an ultrasound source tocause the micro bubbles to create a cavitation effect to destroy nearbytissue. The preferred embodiment utilizes a low frequency ultrasoundsource (less than 500 kHz) to cause the cavitation. A diagnosticinstrument is used to determine the location of the individual surgicallesions.

PCT application WO 02/054018 A2 to Eshel, et al., provides for a methodof lysing adipose tissue in a region of the human body whilesimultaneously not lysing non-adipose tissue. The method describes theuse of HIFU in the body coupled to a diagnostic imaging system and acomputer to track the areas being irradiated with HIFU energy.

The following additional references are relevant in the art: U.S. Pat.Nos. 5,769,790; 6,113,558; 5,827,204; 5,143,063; 5,219,401; 5,419,761;5,618,275; 6,039,048; 6,425,867; 5,928,169; 6,387,380; 6,350,245;6,241,753; 5,526,815; 6,071,239; 5,143,063; and WO 00/36982.

Current methods for using High Intensity Focused Ultrasound (HIFU) toform lesions in biologic tissues via cavitation effects suffer from avariety of practical limitations. In order to reach the intensitiesnecessary for cavitation, previous work has typically involved use ofphysically large (i.e. of diameters greater than 2 cm, typically in therange of 5 to 10 cm) focused transducers at relatively low (i.e. lessthan 1.5 MHz) frequencies and fairly high (i.e. greater than 50 Watts)output energy. Large transducers and high power levels are typicallyrequired at low frequencies in order to reach local intensities at thetransducer focal point of a magnitude sufficient for cavitation. Lowfrequencies, even approaching sonic frequencies (i.e. 20 KHz) may bepreferred for cavitation effects. A physically large transducerpractically limits clinical applications for several reasons.

Physical contact must typically be maintained between the entire activesurface of a large transducer and a patient. This contact is oftenmaintained through a coupling material in order to properly transmit theultrasound energy into the target tissue. Larger transducers are moredifficult to keep properly coupled due to natural contours of tissue.Ideally, there should be no intervening media between the transducer andthe focal volume where the lesion is to be formed that pose largediscontinuities in acoustic properties (thus causing reflections,refraction, and the like). Larger transducers are more difficult toposition so that the entire aperture is clear of intervening media suchas bone or gas pockets that may degrade or destroy the ability to focusproperly. Furthermore, large transducers with very shallow focal depthsare difficult, if not impossible to manufacture and apply properly.Typical ratios of focal depth to aperture size are not less than 1 (anf/1 design). Even if this ratio can be physically decreased, acousticcoupling becomes problematic due to critical angle effects. A standoffcan be used to physically move the transducer away from the targettissue while maintaining coupling, but this has drawbacks in terms ofincreased intensity at the tissue surface, and simply being physicallyunwieldy.

In addition, the focal point of each transducer is at a fixed depthbelow the skin surface and the destruction of adipose tissue using afixed focal length transducer cannot be adjusted by a user. Transducersare manufactured with specific frequencies, amplitudes, focal depths andpower capabilities and these variables cannot be altered after themanufacturing process is complete. The result is that procedures whichattempt to utilize high intensity focused ultrasound to produce adiposetissue destruction through heating, cavitation or some combination ofthe two, are restricted to operate at a particular tissue depth, and areunable to make even slight adjustments to the transducer parametersexcept to completely change transducers. Thus if a patient wishes tohave a volume of adipose tissue treated that is large, such that aliposuction procedure would normally be called for, a high intensityfocused ultrasound device would not be able to handle the depths andbreadths as variables to the operation. Thus high intensity focusedultrasound procedure is still not a better option for the patient sincethe result is restricted to a thin layer of adipose tissue at a fixeddepth below the surface of the skin.

Although liposuction procedures have been refined, and non invasivetechniques and devices are in development, there is still a need for anultrasound transducer that can produce the desired lesion formation tomaximize effective lipolysis treatment in a short exposure time.

There is further a need for a transducer having an adaptive ability toconform to different procedural requirements involving changes infrequency, power output, and activation time.

There is still further a need for a transducer device capable ofdelivering high intensity focused ultrasound to a patient withoutcausing producing skin burns.

BRIEF SUMMARY OF THE INVENTION

Therefore it is an object of the present invention to provide atransducer capable of transmitting high intensity ultrasound energy intotwo or more focal zones simultaneously.

It is another object of the present invention to provide for atransducer capable of focusing two or more different frequencies into asingle focal zone, or into a group of focal zones.

Another object of the present invention is to provide an adaptivetransducer device capable of responding to the demands of differenttreatment requirements.

It is still further an objective of the present invention to provide fora transducer that will eliminate the danger of skin burns on theepidermis of a patient undergoing a lipolysis treatment.

At least one of these objectives is realized in an ultrasound transducersplit into two or more equal size sections wherein each section has adiscrete focal point.

In another embodiment of the present invention is a transducer assemblycomprising a first focused ultrasound transducer operating at a highfrequency for causing bubble formation in adipose tissue and a secondtransducer operating at a low frequency for collapsing the bubblesformed by the first transducer.

Still another embodiment there is an interchangeable electronic medicalinstrument assembly comprising a receptacle having a plurality ofsockets. There is a plurality of electronic medical instruments having acommon style electronic communication plug for engaging the plurality ofsockets. The plurality of electronic medical instruments each have anelectronic identity. A medical appliance is operationally connected tothe receptacle and has at least one signal generator, a data I/O bus,and a power supply wherein the medical appliance can detect and identifyeach electronic medical instrument through the electronic communicationplug when the plugs are engaged in the sockets. The medical appliancecan control each of the electronic medical instruments according to aset of operation parameters.

The electronic medical devices may be ultrasound transducers, sensors,or other electronically controllable medical devices.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 illustrates a schematic of a split focus transducer.

FIGS. 2A-D illustrate various split focus transducers having a commonfocal point.

FIGS. 3A-D show a split focus transducer having two or more focalpoints.

FIGS. 4A-C illustrate a system with a receptacle for a componenttransducer.

FIGS. 5A-B illustrate various receptacle and component types.

DETAILED DESCRIPTION OF THE INVENTION

The ultrasound transducer of the present invention may be either a fixedor variable amplitude ultrasound device. A computer is used to control awaveform generator or an amplifier. Signals from the waveform generatorand amplifier control the operation of the transducer. A user canprogram the signal output from the waveform generator or the amplifierthrough the computer. Direct control of the waveform generator andamplifier are possible if the components have an independent controlelement. An imaging transducer can be utilized in conjunction with thehigh intensity focused ultrasound (HIFU) transducer. The imagingtransducer may be a simple A-line transducer, or a more complex imagingdevice utilizing both a transmit and receive beamformer. Both thediagnostic and therapeutic transducers used in the present invention mayrange from a single fixed focus element to transducer arrays that areelectronically steered to produce complex transmission patterns andresults within a target tissue.

Similarly when we discuss the electronic medical instruments that aretransducers, each medical instrument that produces ultrasound and has anindependent electronic identity is a single transducer for the purposesof the present invention. The restrictive definition provided does notapply when discussing transducers of the prior art. The definition isnecessary to distinguish multiple transducers used together as describedbelow. Furthermore, the description contains references to “elements” ofa transducer, and transducer “sections.” By “element” we refer to thediced partitions from a single die used by a transducer. Each “element”is controlled either individually or in a group by a beam former, signalgenerator or simple amplifier. In contrast a “section” refers to one ormore elements operating as a single transducer. While it istheoretically possible in a phased array to utilize a single transducerto produce multiple focal zones and wave forms simultaneously, thedescription of a “section” herein refers to a separately controlledtransducer from another section, or a physically separate collection ofelements. In this manner, multiple transducer sections can be controlledsimultaneously to produce independent focal zones and/or wave forms.

In a first embodiment of the present invention there is an ultrasoundtransducer split into two or more equal size sections wherein eachsection has a discrete focal point. The transducer may be ahemispherical design or a flat annular array. The transducer is splitinto two halves or four quarters. Depending on the amount of energy thatneeds to be focused into the target area, the number of individualelements can be reduced and the number of partitions the transducer issplit into can be increased. This with a fixed number of elements in asingle transducer, the transducer can be split into as many partitionsas needed or desired. Each partition then is shaped or steered to have adiscrete focal zone different from each other section. The focal zonescan be stacked on top of each other along the axis of the transducer, ordistributed in a three dimensional volume in space before thetransducer. In this way the energy from the transducer can be focusedinto several points at the same time.

Each time the split focus transducer emits ultrasound energy intotissue, the tissue will experience the desired ultrasound effect in morethan one focal volume at a time. Depending on the shape of thetransducer partitions, or the direction of the emission from eachpartition, a varying amount of depth can be treated, or a broader areaat a single depth, or a combination of both.

During the manufacturing process for the transducer, the transducer canbe made as a single focus transducer and then literally cut intopartitions, then the partitions are rejoined so that the focal points ofeach section are distributed as desired. This requires sufficientcapability to rejoin the transducer partitions at varying heights orangles to one other to produce the desired distribution of focal points.

In a second embodiment of the present invention there is a transducerassembly having a first focused ultrasound transducer operating at afirst frequency and a second transducer operation at a second frequency.During use the first transducer emits focused ultrasound energy andproduces cavitation within a focal region. Micro bubbles form in theadipose tissue in response to the first transducer, and the frequency ofultrasound generated. The second transducer operates at a lowerfrequency and is broadcast into the patient's tissue either in focusedmanner or unfocused. If focused the second transducer has a focal regionthat overlaps the focal region of the first transducer. The focal regionof the second transducer may be larger than the focal region of thefirst transducer so as to provide a certain safety margin for theoverlapping volume of the first transducer. The frequency of the secondtransducer is designed to cause the collapse of the bubbles produced bythe first transducer. In this way the first transducer may be fired intoa patient in either pulsed or continuous mode, and as soon as bubblesare formed the second transducer forces them to collapse.

The collapse of the bubbles produces micro volumes of extreme heatdissipation at the moment of collapse of each bubble. The result is thatthe bubbles created in a certain volume of tissue will releasesufficient energy to perform heating necrosis of the local cellpopulation. Yet because the heating occurs from micro bubble collapsingand not from thermal transfer using the ultrasound transducer, there isno danger of burning the patient's skin because of a hot transducer, orover heating the local volume of tissue to produce the desired results.Thus the heating necrosis is done in an extremely short interval of timeinstead of the traditional longer period of time required with simplyheating the tissue to a desired temperature.

It has been known for some time that physically damaging effects fromcavitation may be enhanced by actively causing the collapse of bubbleswith a compression wave. Here bubbles are formed using the firsttransducer and collapsed with the second transducer. The first signalcausing the bubbles to form is a high-frequency transducer (e.g. >1 MHz)wave that can be precisely positioned. The second transducer generates acollapsing wave by emitting low frequency ultrasound (e.g. <1 MHz). Thelow frequency ultrasound may be focused, or may be unfocused so the lowfrequency ultrasound floods the volume of space the high frequencytransducer is focused on.

The high frequency transducer of the transducer assembly is driven by anelectronically controllable signal generator. This provides for thedelivery of 1 to 1000 watts of acoustic energy in either pulsed orcontinuous form. The low frequency transducer of the transducerassembly, may be focused or unfocused and is driven by andelectronically controllable through a signal generator allowing thedelivery of 1 to 1000 watts of acoustic energy in either pulsed orcontinuous form. The high frequency signal generator forms a highfrequency subsystem, and is operated at high power. (e.g. greater than100 watts) with short pulse durations (less than 100 ms). The lowfrequency signal generator forms the low frequency sub system and ispreferably operated in pulse mode. The low frequency sub systempreferably operates at higher power with short pulse durations to forcethe collapse of bubbles formed by the high frequency transducer. Theintense energy release by the collapse of the bubbles damages the tissueto achieve the desired necrotic effect.

In another embodiment of the present invention there is aninterchangeable electronic instrument assembly comprising three types ofcomponents. First a receptacle having a plurality of sockets. Second aplurality of electronic medical instruments that have a common style ofelectronic communication plug for engaging the plurality of sockets,each electronic medical instrument has an electronic identity. Third isa medical appliance in electronic communication with the receptacle andhaving at least one signal generator, a data I/O bus, and a powersupply. The medical appliance can detect and identify each electronicmedical instrument through the electronic communication plug when theinstruments are engaged with the sockets. The medical appliance cancontrol each electronic medical instrument according to a set ofoperation parameters.

This embodiment provides for an interchangeable device that can receivedifferent medical instruments. The receptacle is shaped to have two ormore sockets. The sockets are a uniform design to promoteinterchangeability of parts. The electronic medical instruments may betransducers, sensors (such as thermal, electrical or optical sensors),guides or testing instruments. Each instrument has a socket end and afree end. The socket ends of the medical instruments are uniform indesign so they may be used interchangeably between the sockets. Theelectronic medical instruments each contain the necessary electronics tooperate so long as they receive commands and power from the medicalappliance. When the socket is engaged to the plug of each electronicmedical instrument, the medical appliance queries each instrumentplugged into the receptacle. The medical instruments respond to thequery and identify themselves electronically to the medical appliance.The medical appliance then knows what combination of elements andcapabilities are present in the receptacle.

Thus the affect of a split focus or multipoint focusing transducer canbe achieved using a plurality of transducers as the electronic medicalinstruments. Each transducer having a different focal depth or differentoperating frequency is plugged into the receptacle. The medicalappliance can determine automatically which transducers are present andcontrol the therapeutic distribution of ultrasound automatically.

Multiple transducers designed to produce cavitation in adipose tissuecan be used with the receptacle. In one alternative embodiment, aplurality of small transducers operating at different frequencies can befocused to a common focal point. The affect of the overlappingfrequencies produces the desired cavitation through a beat frequencyeffect. Thus a first transducer may have a first frequency X₁, while asecond transducer has a second frequency X₂. The combination of the twofrequencies at the common focal point generates cavitation, andeliminates the danger of heat accumulation and burning on the surface ofthe patient. Additional frequency transducers can be employed so thebubble forming affect is further distributed out among more physicalcomponents constructed together with the receptacle. Using a split focustransducer as previously described in combination with a plurality ofindividual interchangeable instruments allows for multiple focal zonesto be treated while retaining the advantage of non harmful energy beingtransmitted through the patient until the ultrasound beams converge atthe desired focal zones.

In yet another embodiment, the interchangeable electronic medicalinstrument assembly may use a first imaging transducer to help aphysician direct the ultrasound energy into adipose tissue, and a secondtherapeutic transducer to actually create cavitation in the adiposetissue. The second transducer may be supported by an additionaltransducer to provide for a high and low frequency combination effect,or use one or more split focus transducers to cover a larger volume ofadipose tissue in a single pass.

Turning now to the drawings FIG. 1 provides a simple schematic of thepresent invention. A transducer assembly 600 is illustrated having threecomponent transducers 602, 604, and 606. The three component transducersfocus onto a single focal point 630. Each transducer has an amplifier612, 614, and 616, respectively, and a frequency generator 622, 624,626, respectively, associated with it. Although the illustrationindicates there are three transducers with necessary electronics, thepresent invention is not limited to three. Additional transducers andfocal zones in nearly any combination are possible as shown below.

Alternative embodiments are illustrated in FIGS. 2A-2D. A first splitfocus flat ultrasound transducer, as illustrated in FIGS. 2A and 2B andhas a center transducer 1602 and a annular ring transducer 1604. Thefirst transducer 1602 focuses into a first focal point 1602 f while theannular ring transducer focuses on a second focal point 1604 f. Thefrequencies of the two transducers are preferably different producing aninterference effect at the focal zone. Other variations are permittedwithin the scope of the present invention as where the first transducermay be an imaging transducer and the annular ring may be a therapeuticdevice.

Furthermore the use of additional transducers frequencies and focalzones in a single assembly allow for a great deal of diversity inprocedural outcomes. Three equal sized transducers in a single assemblyare illustrated in FIGS. 2C and 2D. It can be seen here that thoughthere are three partitions of approximately the same area, they need notbe the same shape. This allows for a great complexity in signalinterference to be produced at the focal zone. The signal interferenceallows lower energy signal emissions from the transducers to achieve thesame result. In this manner the tissue along the emission path of eachtransducer is exposed to less dangerous radiant energy than using atransducer having a single frequency and amplitude. The transducer arrayof the present invention allows low energy zones culminating in a singleeffective focal area 1630 (FIG. 2D).

The various frequencies of the transducers 1602, 1604, and 1606 can bemade to provide a therapeutic effect. For example the first transducer1602 may be an imaging transducer allowing a physician to view thetissue where the focal point 630 is projected. The second transducer maybe a high energy high frequency device intended to produce caviation inthe tissue at the site of the focal zone. The third transducer may be alower energy transducer, with a focal point or a broad focal range. Thelow frequency transducer would provide a sound wave to collapse thebubbles caused by the second transducer and produce micro pockets onsudden high temperatures that can cause cellular necrosis.

Alternatively, a split focus transducer 2600 (FIG. 3A) having twosections may be assembled into a single transducer which radiates energyinto two discrete focal zones 2602 f, and 2604 f. The transducerassembly 3600 may be further sub divided into sections 3602, 3604, 3606,and 3608 to produce additional discrete focal zones 3602 f, 3604 f, 3606f, and 3608 f (FIG. 3B). The assembly 3600 can be used to project allthe focal zones in a straight vertical axis (relative to the transducerface, FIG. 3C) or arranged to be spread out in a three dimensionalpattern (FIG. 3D).

A single split focus transducer still has the limitations of not beingadaptive for a variety of medical procedures “on the fly.” An adaptiveHIFU device (FIGS. 4A-C) has receptacle 640 having two or more sockets641 x 1-xn. The sockets within the receptacle are uniform in size andshape allowing each socket to receive any medical device having thecorresponding plug (FIGS. 5A-5B) for the socket type. The receptacle isconnected to a medical appliance 400 having a processor and a set ofprograms for controlling the HIFU devices once they are installed intothe receptacle. Each of these modular medical devices can be fit intothe sockets, and are easily removable. Preferably the interchangeabletransducer elements 602, 604, 606 can engage the socket in a manner thatthe transducer elements are stable and firmly seated within the socketsduring use. However they are easily removable by having an operator pullthem out when desired. Each transducer element 602, 604, 606 contains anidentifying chip or circuit element. The identifying chip allows themedical appliance to query each of the interchangeable transducerelements as soon as the element is plugged into a socket. The transducerelement identifies itself in response to the query with a response code.The response code can be used in a look up table that provides themedical appliance with the information about the transducer element(such as frequency, focal depth, amplitude, and the like). The medicalappliance can now use the information from each of the interchangeableelements to identify what the combination of transducer elements iscapable of. This allows the interchangeable transducer elements, and themedical appliance to serve as a split focus transducer with varyingdepths or focal regions. It further allows the transducer elements to bechanged at any time to adapt the transducer to a wide range of therapyconditions and requirements.

While the description above refers to particular embodiments of thepresent invention, it will be understood that many modifications may bemade without departing from the spirit thereof. The accompanying claimsare intended to cover such modifications as would fall within the truescope and spirit of the present invention.

1. An ultrasound transducer split into two or more equal size sectionswherein each said section has a discrete focal point.
 2. The transducerof claim 1, wherein the ultrasound transducer is a therapeutictransducer.
 3. The transducer as described in claim 1, wherein saidsections are cut from a single transducer die.
 4. The transducer ofclaim 1 being a hemispherical transducer.
 5. The transducer of claim 1being a flat annular array transducer.
 6. The transducer of claim 1,wherein said focal points lay in a single axis.
 7. A transducer assemblycomprising: a first focused ultrasound transducer operating at a highfrequency for causing bubble formation in adipose tissue; and a secondultrasound transducer operating at low frequency for collapsing bubblesformed by said first ultrasound transducer.
 8. The assembly of claim 7,wherein said high frequency transducer and said low frequency transducerare operable between 1 to 1000 watts.
 9. The assembly of claim 7,wherein said low frequency transducer is unfocused.
 10. The assembly ofclaim 7, wherein said first and second ultrasound transducers are pulsewave transducers.
 11. An interchangeable electronic medical instrumentassembly comprising: a receptacle having a plurality of sockets; aplurality of electronic medical instruments having a common style ofelectronic communication plug for engaging said plurality of sockets,said plurality of electronic medical instruments having an electronicidentity; and a medical appliance being in electronic communication withsaid receptacle and having at least one signal generator, a data I/Obus, and a power supply wherein said medical appliance can detect andidentify each electronic medical instrument through said electroniccommunication plug when said plugs are engaged in said sockets, andcontrol each said electronic medical instrument according to a set ofoperation parameters.
 12. The assembly as described in claim 11, whereinsaid plurality of electronic medical instruments are transducers. 13.The assembly as described in claim 12, wherein said plurality ofelectronic medical instruments are ultrasound transducers.
 14. Theassembly as described in claim 11, wherein said plurality of electronicmedical instruments are sensors.
 15. The assembly as described in claim11, wherein said plurality of electronic medical instruments are a firsthigh intensity focused ultrasound transducer, a second imagingultrasound transducer.
 16. The assembly as described in claim 15 furthercomprising a third thermal sensor and a fourth optical sensor.
 17. Theassembly of claim 16, wherein said fourth optical sensor is a trackingdevice.
 18. The assembly of claim 16, wherein said fourth optical sensoris a photo detector.
 19. The assembly as described in claim 11, whereinsaid receptacle and said plurality of electronic medical instruments areisolated within a sealable housing.
 20. The assembly of claim 19,wherein said sealable housing further comprises a means for moving saidreceptacle.